Columns

Apr032018

There is no group of Americans I hold in higher regard than our nation’s veterans. During my time in Congress — as a member of both the House and Senate Veterans Affairs Committees and as chairman of the Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies — I have made improving the quality of life for our nearly 20 million veterans a top priority. I have worked with a deep bench of colleagues who hold the same commitment. Any person or thing detracting from this shared priority does a disservice to our nation’s veterans.

The VA, given its size and scope, has always required strong leadership to keep it functioning. The 2014 wait time scandal in Phoenix revealed the VA’s systemwide dysfunction, forcing veterans to wait weeks and even months to receive much-needed health care. In response to the obvious VA manipulation of veterans’ access to care, Congress intervened to increase oversight, passing the Veterans Access, Choice and Accountability Act — establishing the Veterans Choice Program, or Choice — with overwhelming support.

Choice began to break down the barriers veterans faced in accessing timely care by giving them the choice to seek care in their communities, rather than the VA, if they lived more than 40 miles from a VA facility or if they were unable to receive an appointment in the VA within 30 days.

Choice was enacted to address the gaps that plagued veterans’ access to community care, which has been offered by the VA for decades when VA facilities are unable to provide care a veteran needs. On Jan. 17, then-VA Secretary David Shulkin stated in testimony before the Senate Veterans Affairs Committee, “Demand for community care remains high, with over 32.7 million outpatient medical care appointments completed in fiscal year 2017.” These community appointments account for 36 percent of all outpatient medical care — a four percent increase from the previous fiscal year, growing because of increased demand from veterans.

The cost of care within the VA system is almost five times what the VA spends to meet veterans’ demand for care in the community. The VA should remain a primary and important part of veterans’ lives and there are many who have no need or desire to seek care in the community. However, we must not turn our back on the 1.6 million veterans who want and need Choice and those who rely on access to care in their community or risk not having access to care at all.

The problems at the VA in providing care for our veterans do not stem from a lack of funds — they are the result of a failure of management. I strongly support the thousands of VA employees who have service in their heart to care for our nation’s veterans, and Congress has consistently funded the department’s budget request to better assist those on the ground. However, while the VA’s its budget has more than tripled over the last decade, the challenges veterans face to accessing timely, quality care through the VA’s bureaucracy have not changed. Rather than providing sufficient resources to help our local VA facilities meet demands, the VA has invested in bureaucratic padding for its own headquarters, which has grown by more than 160 percent since 2009. The VA culture continues to drive a status quo that looks out for the VA, not veterans.

It is clear little has changed in VA’s management since the systemic failures and fallout from 2014. The Veterans Choice Program is a solution to help the VA better manage health care for veterans by providing community care, reducing VA bureaucracy and making the department more manageable — but we cannot rely on Choice alone. We must look to VA leadership to change its entrenched “business as usual” mindset.

That is why it is so concerning to me that allegations of “privatizing” VA health care are being used as a distraction from the VA’s solemn responsibility to support those the agency was created to serve. This false narrative diverts attention from the very real problems that persist at the VA and ignores the hard truth: Proposals to reform and consolidate community care were fully supported and endorsed by those who now want to call it privatization. Do not be fooled by this double talk, which unfortunately is all too familiar.

I expect the new leadership at the department will put to rest the disruption and spectacle that has stifled progress on community care reform for the VA. We need the VA to function in service to our veterans and we cannot revert back to the days when veterans were forced to wait weeks or months to access the care they earned. Our nation’s heroes deserve the best our country has to offer.

I will continue to partner with anyone who values the sacred mission of caring for those who have put their lives on the line for our freedoms — and I expect the president’s nominee to be the next VA secretary to lay out his plans to provide strong leadership for this organization in desperate need of change.